Diets high in fructose (added sugars) and high levels of uric acid in the blood are more common in obese children and adolescents with non-alcoholic steato-hepatitis (NASH) than in those with non-alcoholic fatty liver disease (NAFLD) but not NASH, according to recent research.
The study, “Serum uric acid concentrations and fructose consumption are independently associated with NASH in children and adolescents,” was published in the Journal of Hepatology.
Non-alcoholic fatty liver disease (NAFLD) is the accumulation of extra fat in liver cells in people who drink little or no alcohol. A less aggressive form of NAFLD, non-alcoholic steato-hepatitis (NASH), is characterized by steatosis (abnormal retention of fat in cells), swelling of liver cells, and inflammation. It can lead to fibrosis (the accumulation of excess fibrous tissue), cirrhosis (damage that prevents the liver from functioning properly), and even to a form of liver cancer called hepatocellular carcinoma.
The study included 271 obese children and teenagers with NAFLD. Many (37.6%) had NASH. Uric acid concentrations in the blood were measured in all patients, who were also asked to fill out a food frequency questionnaire about when and how often they ate specific foods. Almost 90 percent reported drinking sodas or soft drinks one or more times per week, and nearly 95 percent reported eating snacks in the morning and afternoon.
The concentration of uric acid, a naturally occurring substance in the body, measured in the patients’ blood, and the amount of fructose (a kind of sugar added to food and drinks, especially to sodas and soft drinks) they normally ate, were compared between the group with NASH and the group with NAFLD without NASH.
More patients with NASH had high uric acid concentrations in their blood compared to patients with NAFLD but not NASH (47% vs. 29.7%). Also, high uric acid concentrations and high fructose consumption often occurred together in patients with NASH. High uric acid concentrations in the blood can lead to gout and kidney stones, and are associated with diabetes and other medical conditions.
The investigators concluded that NASH can have a very negative impact on life expectancy and quality of life, and that understanding the factors, such as fructose consumption and high uric acid concentrations in the blood, that put children and teens at risk for it, is crucial to safely treating this young group of patients.